Centro Oncologico Modenese, Dipartimento integrato di Oncologia, Ematologia e Malattie dell'Apparato Respiratorio, Università di Modena e Reggio Emilia, Modena, Italy.
Expert Rev Hematol. 2009 Oct;2(5):549-62. doi: 10.1586/ehm.09.34.
Despite significant improvements in treatment modalities over the 10 years, the clinical course of patients with follicular lymphoma (FL) remains heterogeneous. Thus, prognostic indexes are still required to direct treatment choices and for the design of clinical trials. Investigators have conducted a variety of studies aimed at integrated assessment of biological and clinical features in order to identify novel prognostic factors and scoring systems. Genetic studies focused on tumor cells and the tumor microenvironment represent a step forward in understanding the biology of FL and are likely to provide new prognostic tools for future clinical use. Several prognostic factors have been identified and are currently used in combination to establish prognostic scores and to support therapeutic decisions. The FL International Prognostic Index (FLIPI) is currently used for defining individual risk of death. More recently, FLIPI2 was developed by the same group that built FLIPI as a new model for prognostic definition of patients with FL. The model was defined using prospectively collected data from patients who also received the monoclonal therapeutic antibody rituximab and stratifies patients into three risk categories for disease progression. Since many biological factors are not yet clinically validated or easily assessable, clinical data still represent the major source of prognostic information. The progressive development of new and more effective therapies for the treatment of FL makes the study of prognosis a dynamic and evolving area of clinical research.
尽管在过去 10 年中治疗方式有了显著改善，但滤泡性淋巴瘤 (FL) 患者的临床病程仍然存在异质性。因此，仍然需要预后指标来指导治疗选择和临床试验的设计。研究人员进行了各种旨在综合评估生物学和临床特征的研究，以确定新的预后因素和评分系统。针对肿瘤细胞和肿瘤微环境的遗传研究是理解 FL 生物学的一个进步，并且可能为未来的临床应用提供新的预后工具。已经确定了几个预后因素，并已结合使用以建立预后评分并支持治疗决策。FL 国际预后指数 (FLIPI) 目前用于确定死亡的个体风险。最近，同一组开发了 FLIPI2，作为用于定义 FL 患者预后的新模型。该模型是使用前瞻性收集的来自接受单克隆治疗抗体利妥昔单抗的患者的数据定义的，并将患者分为三个疾病进展风险类别。由于许多生物学因素尚未在临床上得到验证或难以评估，临床数据仍然是预后信息的主要来源。随着新的、更有效的治疗滤泡性淋巴瘤的方法的不断发展，预后研究成为临床研究中一个充满活力和不断发展的领域。
